NHSS 2004

1. Unit 3.7 Nepal Health
Sector Strategy – An Agenda
for Reform 2004
Chetraj pandit
BPH,MPH

2. Introduction
• This health sector strategy is the outcome of the
considerable work that has been carried out by His
Majesty’s Government of Nepal (HMGN), the NGO and
private sectors and External Development Partners
(EDPs) over the last three years.
• This work started with a joint review of the sector in
autumn 1999 and has continued through a series of
workshops and consultations led by the Health Sector
Reform Committee (HSRC) chaired by the Health
Minister and a core group of that committee.

3. The strategy draws on several key HMGN health
sector documents.
• The 1991 National health policy; the second Long
Term Health Plan 1997-2017;
• the strategic analysis to support that plan (May
2000);
• the medium term strategic plan to operationalise
that plan approved in 2001;
• the draft medium term expenditure framework
(MTEF) for the first three years of that plan

4. • There is considerable commitment by HMGN and its EDPs
to poverty reduction and delivering the millennium
development goals (MDGs).
• This is set out in HMGNs Poverty Reduction Strategy Paper
and its fiscal framework, the MTEF.
• The health sector strategy set out in this document, while
setting a strategy for the health sector as a whole, focuses
in particular on how the health sector will make its
contribution to poverty reduction and to improving health
outcomes for the poor and those living in remote areas.
• Its outputs focus on the first five years of the Long Term
Health plan but its strategic aims are those of the plan as a
whole.

5. Situation analysis
Infectious diseases, nutritional disorders, and
maternal and perinatal diseases dominate the
overall pattern of morbidity in Nepal. The
main causes of death and disability are
infectious and parasitic diseases and perinatal
and reproductive ill health.

6. Key issue in health sector
1. How does the government and partner
linkage of out of pocket expenditure that
constitutes 70-75 % of health care
expenditure
2. How does the government and partner
ensure poor and vulnerable to an EHCS
3. How does the government ensure that public
health services are run in most efficient
manner

7. 4. How does the government ensure access to
services outside the EHCS
5. How do you monitoring track sector
performance
6. How do you ensure that the stratigies was
delivered

8. Key element of the strategies
Program outputs strategies
1. The priority elements of an Essential Health Care
Service – safe motherhood and family planning, child
health, control of communicable disease, strengthened
out patient care – will be costed, allocated the
necessary resources and implemented. Clear systems
will be in place to ensure that the poor and vulnerable
have priority for access.
2. Local bodies will be responsible and capable of
managing health facilities in a participative,
accountable and transparent way with effective
support from the MoH and its sector partners.

9. 3. The role of the private sector and NGOs in the
delivery of health services will be recognised
and developed with participative
representation at all levels. Clear systems are
in place to ensure consumers get access to
cost effective high quality services which offer
value for money.

10. Programme output 1: Essential Health Care
Services
Programme output 2: Local bodies will be
responsible and capable of managing health
facilities in a participative, accountable and
transparent way with effective support from
the MoH and its sector partners
Programme Output 3: The role of the private
sector and NGOs in the delivery of health
services is recognised and developed with
participative representation at all levels.

11. Sector management output strategies
1. There will be co-ordinated and consistent Sector
Management (planning, programming,
budgeting, financing and performance
management) in place within the MoH to
support decentralised service delivery with the
involvement of the NGO and private sectors.
2. Sustainable development of health financing and
resource allocation across the whole sector
including alternative financing schemes will be
in place.

12. 3. A structure and systems will be established and
resources allocated within the MoH for the
effective management of physical assets and
procurement and distribution of drugs, supplies
and equipment.
4. Clear and effective Human Resource
Development policies, planning systems and
programmes will be in place.
5. A comprehensive and integrated management
information system for the whole health sector
will be designed and implemented at all levels

13. Sector Management Output 1: There will be co-
ordinated and consistent Sector Management
(planning, programming, budgeting, financing
and performance management) in place
within the MoH to support decentralised
service delivery and the involvement of the
NGO and private sectors.

14. Sector Management Output 2: Sustainable
development of health financing and resource
allocation across the whole sector including
alternative financing schemes will be in place
Sector Management Output 3: Structure and
systems will be established and resourced
within MoH for the effective management of
physical assets and procurement and
distribution of drugs, supplies and equipment.

15. Sector Management Output 4: Clear and
effective Human Resource Development
policies and systems and programmes will be
in place.
Sector Management Output 5: comprehensive
and integrated management information
system for the whole health sector is designed
and implemented at all levels

16. Thank you